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3% vs 12.7%; p0.0001), mainly driven by events occurring beyond the peri-procedural period. The annualized rate of ischemic stroke or TIA was similar in patients with and without MB (2.3% vs 3.3%; p=0.446). MB post-LAAO was a strong independent predictor of mortality (HR 3.07; 95% CI 2.15-4.4. In real-world patients at high bleeding risk, MB following LAAO was not uncommon and associated with a significant increase in mortality, without increasing the risk of stroke. In real-world patients at high bleeding risk, MB following LAAO w